New York: On this International Day of Yoga (IDY), India’s 69.2 million diabetics might consider waking up to a spoonful of methi seeds soaked overnight on an empty stomach, followed by with meals of salads fresh fruits, multigrain rotis and brown rice gruels.
This is part of the ideal sattvic diet for diabetics, according to the Central Council for Research in Yoga and Naturopathy (CCRYN), a body of the Ministry of AYUSH, most recently in the news for advising pregnant women to “detach themselves from desire, anger, attachment, hatredness [sic] and lust”.
The pamphlet on Mother and Child Care, distributed by AYUSH minister Shripad Yesso Naik, in the run up to the IDY, is scarcely the only document advising lifestyle and dietary practices. The aforementioned diet is part of a similar booklet on the benefits of yoga and naturopathy on diabetes, one of India’s most prevalent non-communicable disease (NCD). Dr. Ishwara Acharya, president of the CCRYN told News18 that these practices could rid India of NCDs.
Much of this advice, however, is treated warily by nutritionists.
“AYUSH diets endorse ‘sattvic’ philosophy, which is fine, but does not mean that people who have been consuming non-vegetarian foods are not eating healthy. In fact, several nutrients are only found in non-vegetarian foods like long chain omega 3 fats, vitamin B12 etc,” said Dr. Shweta Khandelwal, nutritionist and associate professor, Public Health Foundation of India (PHFI).
Nor is the humble egg, disdained by the sattvic diet, easily substituted. Khandelwal did the math. One egg has the biological value (BV) — the unit for measuring how much protein a food source provides the body — of 100. One whole egg makes available 6 gram of protein for the body. Thus eggs are an excellent source of protein. However, she explained, many of the vegetarian sources of protein have a low BV. Thus one has to consume about three to four bowls (200-250 ml each) of dal to get as much bioavailable protein.
Protein requirements are still easier to achieve with a vegetarian diet for an adult, said Purnima Menon, senior fellow at the International Food Policy Research Institute (IFPRI); the trouble would be with iron, zinc and calcium. In a country with widespread anemia among girls and women, which affects lifelong health and makes pregnancy more dangerous, iron is hard to ignore.
According to Acharya, naturopathic diets could correct menstrual cycles from puberty on, perhaps stopping the loss of iron from excess bleeding. He was careful to add that the CCRYN was not asking anyone to stop taking supplements, even though naturopathy is a drugless system.
However, iron has limited vegetarian sources — certain leafy vegetables or lentils — Menon said. These are either expensive or not readily available.
The latest antenatal guidelines by the World Health Organisation recommend “consumption of a variety of foods, including green and orange vegetables, meat, fish, beans, nuts, whole grains and fruit” for healthy pregnancies.
Even if an AYUSH prescribed diet fulfills one’s nutritional needs, it trips over accessibility and affordability, as pointed out by both Khandelwal and Menon.
Seasonal fruits, prescribed for diabetics, are often priced too highly for urban poor to afford, who have now become increasingly vulnerable to diabetes according to the ongoing diabetes survey of the Indian Council of Medical Research. As are the dry fruits to be consumed by pregnant women.
“Consuming a balanced and nutritious diet is a problem across all classes and sectors,” said Khandelwal, adding “With the rise in working populations and erratic lifestyles we all often fall prey to cheap, ready-to-eat options, which are mostly empty calories laden with trans fats.”
However, the minutely detailed AYUSH diets are more suited to those either leading a life of leisure or who have enough help at home with the amount of preparation required.
Menon, who works at the Health and Nutrition Division at IFPRI, said the prescribed diet, at least for pregnant and lactating women would take significant efforts in terms of time and resources. “It takes time to procure and process, things like alfalfa and sprouts,” said Menon, “and many pregnant women do not have the time, the access or the support.” For many women, it will be hard to adhere to fruits and sprouts at 7am, whole wheat rotis at 11am and juices at 3pm.
Recently having completed a study on nutrition and behavioural changes in pregnant women in Bangladesh, Menon called it impractical to expect women to make drastic changes in their diet at the moment of pregnancy. Acharya may call naturopathy a change of lifestyle. However, “changes, and recommendations on what changes to make, to add those extra 350 to 400 calories and other nutrients to a pregnant woman’s diet, have to be incremental and contextual,” said Menon. People form habits by eating multiple times a day, every day. One cannot expect women from coastal communities to suddenly stop eating fish, a ready source of protein. In India, diverse socio-agricultural diversity, a daily family diet in Kerala would be very different from Gujarat or from any other state, she said.